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Uveitis is a form of eye inflammation. It affects the middle layer of tissue in the eye wall (uvea).
Uveitis (u-vee-I-tis) warning signs often come on suddenly and get worse quickly. They include eye redness, pain and blurred vision. The condition can affect one or both eyes, and it can affect people of all ages, even children.
Possible causes of uveitis are infection, injury, or an autoimmune or inflammatory disease. Many times a cause can’t be identified.
Uveitis can be serious, leading to permanent vision loss. Early diagnosis and treatment are important to prevent complications and preserve your vision.
Symptoms
Eye with uveaOpen pop-up dialog box
The signs, symptoms and characteristics of uveitis may include:
Eye redness
Eye pain
Light sensitivity
Blurred vision
Dark, floating spots in your field of vision (floaters)
Decreased vision
Symptoms may occur suddenly and get worse quickly, though in some cases, they develop gradually. They may affect one or both eyes. Occasionally, there are no symptoms, and signs of uveitis are observed on a routine eye exam.
The uvea is the middle layer of tissue in the wall of the eye. It consists of the iris, the ciliary body and the choroid. When you look at your eye in the mirror, you will see the white part of the eye (sclera) and the colored part of the eye (iris).
The iris is located inside the front of the eye. The ciliary body is a structure behind the iris. The choroid is a layer of blood vessels between the retina and the sclera. The retina lines the inside of the back of the eye, like wallpaper. The inside of the back of the eye is filled with a gel-like liquid called vitreous.
The type of uveitis you have depends on which part or parts of the eye are inflamed:
Anterior uveitis affects the inside of the front of your eye (between the cornea and the iris) and the ciliary body. It is also called iritis and is the most common type of uveitis.
Intermediate uveitis affects the retina and blood vessels just behind the lens (pars plana) as well as the gel in the center of the eye (vitreous).
Posterior uveitis affects a layer on the inside of the back of your eye, either the retina or the choroid.
Panuveitis occurs when all layers of the uvea are inflamed, from the front to the back of your eye.
When to seek medical advice
Contact your doctor if you think you have the warning signs of uveitis. He or she may refer you to an eye specialist (ophthalmologist). If you’re having significant eye pain and unexpected vision problems, seek immediate medical attention.
Causes
In about half of all cases, the specific cause of uveitis isn’t clear, and the disorder may be considered an autoimmune disease that only affects the eye or eyes. If a cause can be determined, it may be one of the following:
An autoimmune or inflammatory disorder that affects other parts of the body, such as sarcoidosis, ankylosing spondylitis, systemic lupus erythematosus or Crohn’s disease
An infection, such as cat-scratch disease, herpes zoster, syphilis, toxoplasmosis or tuberculosis
Medication side effect
Eye injury or surgery
Very rarely, a cancer that affects the eye, such as lymphoma
Risk factors
People with changes in certain genes may be more likely to develop uveitis. Cigarette smoking has been associated with more difficult to control uveitis.
Complications
Left untreated, uveitis can cause complications, including:
Prosthetic contact lenses are prescribed to mask flaws and improve the appearance of an eye disfigured from a birth defect, trauma, or eye disease.
If certain structures of the injured or disfigured eye also fail to function properly, special prosthetic lenses can be designed to block excess light from reaching the back of the eye to reduce glare and increase comfort.
Your eye care practitioner can match prosthetic contact lenses to the appearance of a healthy eye by using a pre-made trial set or by ordering custom-painted contact lenses.
Like regular contact lenses, prosthetic contacts can be made of gas permeable or soft lens materials. And most prosthetic lenses can be cleaned and disinfected using the same multipurpose contact lens solutions recommended for conventional soft or gas permeable lenses.
Custom prosthetic lenses can be made in a wide variety of lens powers to correct nearsightedness, farsightedness and/or astigmatism, or they can be produced without corrective power to simply provide a more natural appearance to a blind or disfigured eye.
Eye Conditions That May Benefit From Prosthetic Contact Lenses
Many injuries, conditions and infections can lead to disfigurement of an eye and make an individual feel self-conscious about his or her appearance. Prosthetic lenses can be specially designed to match the appearance of the unaffected eye as closely as possible and make the disfigured eye less conspicuous.
Disfiguring conditions frequently treated with prosthetic contact lenses include incomplete formation of the pupil (aniridia), lack of pigment or color in the eye (albinism) and damage to the cornea from trauma.
People with albinism or other eye conditions creating light sensitivity (photophobia) can benefit from prosthetic lenses that reduce the amount of light entering the eye. Prosthetic lenses also are sometimes used to eliminate double vision (diplopia) caused by certain eye conditions.
Special prosthetic colored contact lenses sometimes are used to improve vision in cases of childhood amblyopia. Two identical-appearing colored contacts are worn, but one lens has an opaque pupil painted on it to block (occlude) light from entering the eye. This lens is worn on the eye with normal sight, forcing greater use of the amblyopic eye to improve vision development in the affected eye.
Occlusion therapy with prosthetic contact lenses can be more effective for treating amblyopia than the use of an eye patch, which children often resist or remove due to embarrassment. But amblyopia treatment with contacts is more expensive due to the cost of the prosthetic lenses.
How Prosthetic Contact Lenses Are Prescribed
The first step in being fit with prosthetic contact lenses is to have a comprehensive eye exam. During this exam, your optometrist or ophthalmologist will thoroughly examine your eyes to rule out conditions that might interfere with successful prosthetic contact lens wear.
The second step is to undergo a contact lens fitting. In addition to performing the steps in a normal contact lens exam and fitting, your eye doctor may also take close-up photographs of your eyes. These color photos are sent to the prosthetic contact lens manufacturer to help the company create a prosthetic lens that matches your natural eye color and appearance as closely as possible.
Some eye doctors who specialize in contacts for hard-to-fit eyes also may have fitting sets of sample prosthetic lenses on hand so you can get an immediate idea of how effectively the lenses can restore a natural appearance to your affected eye(s).
Have you ever had a headache that affected your vision? Sometimes a headache can cause pain around your eyes, even though the headache is not associated with a vision problem. On the other hand, a headache may be a sign that your eyes are changing and that it’s time to schedule an eye exam. Although headaches are rarely a medical emergency, a severe one should not be ignored or minimized.
Headaches That Affect Vision
Vision problems can sometimes be the consequence of a headache. This is especially true with migraines and cluster headaches.
Migraine Headache
A migraine headache can cause intense pain in and around your eyes. A migraine aura resembling flashing lights, a prismatic rainbow of lights or a zig-zag pattern of shimmering lights often precedes the actual headache. The aura typically lasts around 20 minutes.
Some people who experience a migraine aura never develop the actual headache, making the diagnosis of the visual disturbances difficult.1 Migraines can also cause tingling or numbness of the skin. People with severe migraines may experience nausea, vomiting, and light sensitivity. Medications, certain foods, smells, loud noises, and bright lights can all trigger a migraine headache.An Overview of Migraine With Aura
Cluster Headache
Cluster headaches are severe headaches that occur in clusters and typically cause pain around the eyes. The pain often radiates down the neck to include the shoulder. Other symptoms include:
Cluster headaches may occur daily for several months at a time followed by a long period with no headaches. It is not known what causes cluster headaches, but they are clearly one of the most severe headaches one can experience.
Vision Problems That Cause Headaches
On the flip side, vision problems can cause headaches when you either overwork the eyes or struggle to maintain focus. By correcting the vision problem, you can often resolve the headache.
Eye Strain
Simply overusing the focusing muscles of your eyes can cause eye strain and headaches. This is an increasing problem in our high tech world
Small-screen texting and web browsing can easily cause eye strain, in part because the words and images on a computer screen are made up of pixels and do not have well-defined edges. The eyes cannot easily focus on pixels, so they must work harder even if an image is in high-resolution.2 When the eye muscles become fatigued, a headache can develop around or behind the eyes.
Farsightedness
Adults and children with uncorrected farsightedness (hypermetropia) will often experience a frontal headache (also known as a “brow ache”). If you are farsighted, you may find it difficult to focus on nearby objects, resulting in eye strain and headaches. As you subconsciously compensate for your farsightedness by focusing harder, the headaches can become worse and more frequent.
Presbyopia
Around the age of 40, people begin to find it difficult to focus on nearby objects. Near point activities, such as reading or threading a needle, are often difficult to perform because of blurring. This is an unavoidable condition known as presbyopia that affects everyone at some point. Headaches develop as you try to compensate for the lack of focusing power. Reading glasses can often relieve the underlying eye strain.
Also known as temporal arteritis, giant cell arteritis (GCA) is an inflammation of the lining of the arteries that run along the temple. GCA usually creates a headache that causes constant, throbbing pain in the temples. Vision symptoms occur as a result of a loss of blood supply to the optic nerve and retina. Other symptoms include:
Fever, fatigue and muscle aches
Scalp tenderness
Pain while chewing
Decreased vision
GCA is considered a medical emergency. If left untreated, the condition may cause vision loss in one or both eyes. A delayed diagnosis is the most common cause of GCA-associated vision loss.42:18
What Is a Retinal Migraine?
Acute Angle-Closure Glaucoma
Acute angle-closure glaucoma (AACG) is a rare type of glaucoma that causes a sudden onset of symptoms, including headaches. Eye pressure rises quickly in AACG causing increased eye redness, eye pain, and cloudy vision. A mid-dilated pupil (in which pupil dilation is sluggish and incomplete) is one of the most important diagnostic features of AACG.5
Ocular Ischemic Syndrome
Ocular ischemic syndrome (OIS) is a condition that develops due to a chronic lack of blood flow to the eye. This condition often causes a headache, decreased vision, and a host of other signs, including cataracts, glaucoma, iris neovascularization (the development of new weak blood vessels in the iris), and retinal hemorrhage. White spots on the retina indicate a lack of blood flow and oxygen to the retinal tissue.2:18
What Is a Retinal Migraine?
Herpes Zoster
Also known as shingles, herpes zoster is known for causing headaches, vision changes and severe pain around the head and eye. Herpes zoster is a reactivation of the chickenpox virus and affects a single side of the body. A headache usually precedes an outbreak of painful skin blisters.
Herpes zoster around the eyes is serious and requires immediate medical attention (including antiviral medication) to prevent damage to the ocular nerves and eyes. Complications include corneal clouding, glaucoma, and optic nerve atrophy (deterioration).6
Pseudotumor Cerebri
Pseudotumor cerebri is a condition that occurs when the pressure within the skull increases for no apparent reason. For this reason, pseudotumor cerebri is also referred to as Idiopathic Intracranial hypertension (“idiopathic” meaning of unknown origin and “hypertension” meaning high blood pressure).
Pseudotumor cerebri often causes a headache and changes in vision. If left untreated, pseudotumor cerebri can lead to vision loss as the pressure places strain on the optic nerves. Fortunately, while 65% to 85% of people with pseudotumor cerebri will experience visual impairment, the condition is usually transient and will normalize when the hypertension is controlled.
There are two main types of glare reducing lenses for eyewear: lenses with an anti-reflective coating and polarized lenses. Both help to prevent glare in their own way. Glare reducing lenses can improve vision clarity, help people see better while driving at night, reduce annoying glare from water or other horizontal surfaces, and eliminate noticeable reflections on a lens itself.
What is glare?
Glare is caused by light bouncing off of a reflective surface. When talking about eyewear, people are most likely referring to lens glare or environmental glare. Lens glare is caused by the reflection of light off the surface of a lens. Whether it belongs to a camera, telescope, binoculars, or even just glasses, all lenses have some level of reflection with the lowest amount of reflection being less than 0.1%. Eyeglass lenses without a glare-reducing coating typically allow around 90% of light to pass through, depending on the lens material. The other 10% of the light reflects off the surfaces of the lens. The glare caused by this 10% reduces vision clarity, causes people to see halos around headlights and street lamps at night, and creates bright, almost white reflections on the lens itself.
Environmental glare is caused by light waves reflecting off of flat surfaces like water or the highway. It becomes focused and travels in a uniform direction parallel to that surface, creating a bright and intense reflection that we call glare. This type of glare affects everyone, regardless of whether or not they wear glasses.
While it may be impossible to eliminate 100% of the glare on glasses lens, technology has helped to get the number as close to 0 as possible. While both anti-reflective coatings and polarized lenses help to reduce glare, the technology behind these two is quite different. An anti-reflective coating (also known as AR or anti-glare coating) actually encourages more light to pass through a lens. When more light passes through, less light reflected off its surfaces, and thus, less glare.
Polarized lenses, on the other hand, reduce glare by absorbing light waves from a certain orientation. Most polarized lenses for eyewear are oriented to absorb horizontal light waves reflected off of flat surfaces like a lake or the snow-covered ground.
When it comes to eyewear, AR coatings are applied both eyeglass lenses and sunglass lenses. Anti-glare coating is applied to both sides of a lens to prevent light from reflecting off the back of the lens as well. Polarized lenses are typically used for sunglasses since the nature of its glare reducing technology is to block light instead of letting more through.
The benefits of glare reducing lenses
Many people question whether or not it’s worth it to get glare reducing lenses. The short answer is: while not everyone may need sunglasses with polarized lenses, lenses with an anti-reflective coating will vastly improve the quality of life for a glasses wearer.
Lens glare is a major source of eye strain since it reduces vision clarity, forcing your eyes to work harder to focus. People who work with computers are especially susceptible to this type of eye strain since illuminated screens act as a direct and constant source of glare on lenses. Adding AR coating to your lenses significantly lessens this glare, helps you see more clearly, and reduces eye strain caused by computer screens.
Glares called “halos” can be seen around the headlights of cars and street lamps. These halosare a great source of discomfort and distraction for glasses wearers who drive at night. They reduce visibility and make nighttime driving difficult. Anti-glare coating prevents these halos and helps to make driving at night safer for glasses wearers.
If you’re someone who is both literally and figuratively in the spotlight a lot, anti-reflective coating is a must. Glare caused by bright lights reflecting off a lens can be distracting. It also obscures your eyes, making it harder for people to find direct eye contact with you. So if you have a client- or customer-facing job, make sure to consider getting glare reducing glasses.
Finally, if you’re someone who spends a lot of time out on the water or working in the snow, you’re well aware of how much glare can reduce visibility and make it a literal pain to be outside. The tint on sunglasses with polarized lenses helps to reduce that all around brightness, while the polarization helps to save your eyes from blinding glare.
So for the best comfort while wearing glasses or sunglasses, consider glare reducing lenses. Not only will they help you see better, but they’ll also help you get the most out of life. At EyeBuyDirect, you can find affordable glare reducing lenses for any of our great styles.
To Be the Region’s Leading Eye Care Provider, Delivering the Most Advanced, Specialized Eye Care Services in a Compassionate, Patient-Centered Approach.
The AREDS reports support the following 10 nutrient-rich foods:
1. Fish
Many fishes are rich sources of omega-3 fatty acids.
Oily fish are fish that have oil in their gut and body tissue, so eating them offers higher levels of omega-3-rich fish oil. The fish that contains the most beneficial levels of omega-3s include:
tuna
salmon
trout
mackerel
sardines
anchovies
herring
Some studies have found that fish oil can reverse dry eye, including dry eye caused by spending too much time on a computer
2. Nuts and legumes
Nuts are also rich in omega-3 fatty acids. Nuts also contain a high level of vitamin E, which can protect the eye from age-related damage.
Nuts are available for purchase in most grocery stores and online. Nuts and legumes that are good for eye health include:
Carrots are rich in both Vitamin A and beta carotene. Beta carotene gives carrots their orange color.
Vitamin A plays an essential role in vision. It is a component of a protein called rhodopsin, which helps the retina to absorb light.
Research on beta carotene’s role in vision is mixed, though the body needs this nutrient to make vitamin A.
7. Sweet potatoes
Like carrots, sweet potatoes are rich in beta carotene. They are also a good source of the antioxidant vitamin E.
8. Beef
Beef is rich in zinc, which has been linked to better long-term eye health. Zinc can help delay age-related sight loss and macular degeneration.
The eye itself contains high levels of zinc, particularly in the retina, and the vascular tissue surrounding the retina.
Meats such as chicken breast and pork loin also contain zinc, but at lower levels than beef.
9. Eggs
Eggs are an excellent source of lutein and zeaxanthin, which can reduce the risk of age-related sight loss. Eggs are also good sources of vitamins C and E, and zinc.
10. Water
It may come as no surprise that a fluid essential to life is also vital to eye health.
Drinking plenty of water can prevent dehydration, which may reduce the symptoms of dry eyes.
Recommended daily intake
The current daily recommendations for healthy eye nutrients, as suggested by the AAO to slow the progression of eye disease, are:
500 milligrams (mg) of vitamin C
400 international units of vitamin E
10 mg lutein
2 mg zeaxanthin
80 mg of zinc oxide
2 mg of copper oxide
Other eye health tips
According to the AAO, the following strategies can help to ensure healthy eyes:
wearing sunglasses outside, since excessive sun exposure can cause cataracts. A range of sunglasses is available for purchase online.
stopping smoking
getting regular eye exams, particularly if there is a family history of eye disease
wearing eye protection when working with possible eye irritants or dangerous chemicals
washing hands before applying contacts
wearing contacts only for the period recommended by the doctor or manufacturer
protecting eyes from computer-related eye strain by looking away every 20 minutes at something 20 feet away, for 20 seconds
Diabetes is a leading cause of blindness. People with diabetes should carefully monitor blood sugar levels, take medications exactly as prescribed by their doctor, and manage carbohydrate intake while focusing on eating low-moderate glycemic index (GI) foods.
Early treatment for eye health problems can prevent them from getting worse. So people who notice changes in their vision should schedule a comprehensive eye exam with an optometrist or ophthalmologist.
Age-related macular degeneration (AMD) is the most common cause of irreversible central vision loss in older patients. Dilated funduscopic findings are diagnostic; color photographs, fluorescein angiography, and optical coherence tomography assist in confirming the diagnosis and in directing treatment. Treatment is with dietary supplements, intravitreal injection of antivascular endothelial growth factor drugs, laser photocoagulation, photodynamic therapy, and low-vision devices.
, MD, Vitreoretinal Diseases and Surgery Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University
Professional.Manuals.TopicPage.LastRevisionDate| Content last modified Jun 2019
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Age-related macular degeneration (AMD) is the most common cause of irreversible central vision loss in older patients. Dilated funduscopic findings are diagnostic; color photographs, fluorescein angiography, and optical coherence tomography assist in confirming the diagnosis and in directing treatment. Treatment is with dietary supplements, intravitreal injection of antivascular endothelial growth factor drugs, laser photocoagulation, photodynamic therapy, and low-vision devices.
AMD is the leading cause of permanent, irreversible vision loss in older adults. It is more common among whites.
Etiology
Pathophysiology
Two different forms occur:
Dry (nonexudative or atrophic): All AMD starts as the dry form. About 85% of people with AMD have only dry AMD.
Wet (exudative or neovascular): Wet AMD occurs in about 15% of people.
Normal Retina
IMAGE PROVIDED BY SUNIR GARG, MD.
Although only 15% of patients with AMD have the wet form, 80 to 90% of the severe vision loss caused by AMD results from wet AMD.
Age-Related Macular Degeneration (Wet)
PAUL WHITTEN/SCIENCE PHOTO LIBRARY
Dry AMD causes changes of the retinal pigment epithelium, typically visible as dark pinpoint areas. The retinal pigment epithelium plays a critical role in keeping the cones and rods healthy and functioning well. Accumulation of waste products from the rods and cones can result in drusen, which appear as yellow spots. Areas of chorioretinal atrophy (referred to as geographic atrophy) occur in more advanced cases of dry AMD. There is no elevated macular scar (disciform scar), edema, hemorrhage, or exudation.
Wet AMD occurs when new abnormal blood vessels develop under the retina in a process called choroidal neovascularization (abnormal new vessel formation). Localized macular edema or hemorrhage may elevate an area of the macula or cause a localized retinal pigment epithelial detachment. Eventually, untreated neovascularization causes a disciform scar under the macula.
Symptoms and Signs
Dry AMD
The loss of central vision occurs over years and is painless, and most patients retain enough vision to read and drive. Central blind spots (scotomas) usually occur late in the disease and can sometimes become severe. Symptoms are usually bilateral.
Funduscopic changes include the following:
Changes in the retinal pigment epithelium
Drusen
Areas of chorioretinal atrophy
Wet AMD
Rapid vision loss, usually over days to weeks, is more typical of wet AMD. The first symptom is usually visual distortion, such as a central blind spot (scotoma) or curving of straight lines (metamorphopsia). Peripheral vision and color vision are generally unaffected; however, the patient may become legally blind (< 20/200 vision) in the affected eye, particularly if AMD is not treated. Wet AMD usually affects one eye at a time; thus, symptoms of wet AMD are often unilateral.
Funduscopic changes include the following:
Subretinal fluid, appearing as localized retinal elevation
Retinal edema
Gray-green discoloration under the macula
Exudates in or around the macula
Detachment of retinal pigment epithelium (visible as an area of retinal elevation)
Subretinal hemorrhage in or around the macula
Age-Related Macular Degeneration (Drusen)
PAUL PARKER/SCIENCE PHOTO LIBRARY
Diagnosis
Funduscopic examination
Color fundus photography
Fluorescein angiography
Optical coherence tomography
Both forms of AMD are diagnosed by funduscopic examination. Visual changes can often be detected with an Amsler grid. Color
Treatment
Dietary supplements for high-risk dry or unilateral wet AMD
Intravitreal antivascular endothelial growth factor drugs or laser treatments for wet AMD
Supportive measures
Dry AMD
There is no way to reverse damage caused by dry AMD. Patients with extensive drusen, pigment changes, and/or geographic atrophy can reduce the risk of developing advanced AMD by 25% by taking daily supplements of the following:
Zinc oxide 80 mg
Copper 2 mg
Vitamin C 500 mg
Vitamin E 400 units
Lutein 10 mg/zeaxanthin 2 mg (or beta-carotene 15 mg or vitamin A 28,000 units for patients who have not smoked)
In current and former smokers, beta-carotene can increase the risk of lung cancer. Recently, substitution of beta-carotene with lutein plus zeaxanthin has been shown to have comparable efficacy (1). Therefore, such a substitution should be considered in current or former smokers. The zinc component of these supplements increases risk of hospitalization for genitourinary tract disorders. Some patients taking beta-carotene also have yellowing of the skin. Reducing cardiovascular risk factors as well as regularly eating foods high in omega-3 fatty acids and dark green leafy vegetables may help slow disease progression; however, recent large trials have not shown that taking supplements of omega-3 fatty acids reduces disease progression.
Wet AMD
Patients with unilateral wet AMD should take the daily nutritional supplements that are recommended for dry AMD to reduce the risk of AMD-induced vision loss in the other eye. The choice of other treatments depends on the size, location, and type of neovascularization. Intravitreal injection of antivascular endothelial growth factor (anti-VEGF) drugs (usually ranibizumab, bevacizumab, or aflibercept) can substantially reduce the risk of vision loss and can help restore reading vision in up to one third of patients. In a small subset of patients, thermal laser photocoagulation of neovascularization outside the fovea may prevent severe vision loss. Photodynamic therapy, a type of laser treatment, also helps under specific circumstances. Corticosteroids (eg, triamcinolone) are sometimes injected intraocularly along with an anti-VEGF drug. Other treatments, including transpupillary thermotherapy, subretinal surgery, and macular translocation surgery, are seldom used.
Treatment reference
1. Age-Related Eye Disease Study 2 Research Group: Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: The age-related eye disease study 2 (AREDS2) randomized clinical trial. JAMA 309(19):2005-15, 2013. doi: 10.1001/jama.2013.4997. Clarification and additional information. JAMA 310(2):208, 2013. doi:10.1001/jama.2013.6403.
Supportive measures
For patients who have lost central vision, low-vision devices such as magnifiers, high-power reading glasses, large computer monitors, and telescopic lenses are available. Also, certain types of software can display computer data in large print or read information aloud in a synthetic voice. Low-vision counseling is advised
Key Points
AMD is more common among whites and is the leading cause of permanent vision loss in older adults.
AMD can be dry (nonexudative or atrophic) or wet (exudative or neovascular).
Although 85% of AMD is dry, 80 to 90% of severe vision loss caused by AMD results from the wet type.
Funduscopic changes in dry AMD include drusen, areas of chorioretinal atrophy, and changes to the retinal pigment epithelium.
Funduscopic changes in wet AMD include retinal edema and localized elevation, detachment of the retinal pigment epithelium, a gray-green discoloration under the macula, and exudates in and around the macula.
If patients have AMD on funduscopy, do color fundus photography, fluorescein angiography, and optical coherence tomography.
Prescribe dietary supplements for unilateral wet or high-risk dry AMD.
Treat wet AMD with intravitreal antivascular endothelial growth factor drugs or laser therapy.